Family Name
First name
Mr/Mrs/Miss/Ms
Date of birth
Nationality
First language
Occupation
Address
Courses
Course title (1)
Course title (2)
Course dates (1)
From
To
Course dates (2)
From
To
Accomodation
Not
required
Halls of residence
Host
family
Accomod. arrival date
Smoker ?
yes
no
Departure date
Special diet ?
yes
no
Details
Language profile
What is your level of english now ?
zero
Poor
Average
Very Good
Excellent
How long have you studied english in your country ?
At school
Since school
Have you studied in an English-speaking Country before ?
yes
no
Where
when
How long for
At what level ?
Have you taken any language examinations ? yes
no
Which examination/level ?
Which skill(s) are most difficult/important for you ?
Reading
Writing
Listening
Speaking
What are your reason for studying English now ?
To reserve a place:
Return this enrolment form with a non-refundable course deposit of £ 100, and a non-refundable accomodation deposit of £ 75.00 if you want accomodation arranged by the Centre for Language Study.
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